Acne can damage both your skin and your self-confidence. From pinpointing symptoms and diagnosis to learning about myths and treatment options, we explore everything you need to know about acne.
Your first experience with acne is during your teens as hormones rise, changing your body and making your skin produce more of its natural oil, sebum. Acne grows in pores, the small holes in your skin, which can get clogged with dead skin, sebum and dirt. This bacteria-friendly environment soon triggers your immune system and, as the body fights the bacteria-rich debris, a pimple forms. You may experience:
– Pustules, which are pimples that have a red base with pus on top
– Cysts, which are deep, painful and pus filled pimples that scar
– Nodules, which are large, painful, and generally solid masses deep beneath the skin
– Blackheads, also called comedones, which are black pimples rising to the skin’s surface
– Whiteheads, which are pimples that stay under the skin’s surface and have a white tip
– Papules, which are small, tender bumps that may look pink or reddish
While it often starts with puberty and is associated with teenagers, adults also develop acne. Since pimples appear in several forms, adults may mistake acne for another skin condition. Most acne outbreaks run a predictable four-to-eight-week course, when treated with face washes, scrubs or masks containing salicylic acid (aspirin’s active ingredient) or benzoyl peroxide. Unfortunately, you may need a doctor’s help if you have cysts, a lot of pimples or nodules.
While looking at your skin, your doctor, usually a dermatologist, grades your acne’s severity using one of three scales. The Pillsbury, the simplest of the three, rates acne’s severity on a scale of one (least severe) to four (most severe). The Leeds grading system has the doctor counting your blemishes, separating them into two categories (inflammatory and non-inflammatory) and rating them on a scale of zero to 10. If using the Cook’s system, your doctor rates your acne’s severity from zero (least severe) to eight (most severe).
Doctors also consider your age when diagnosing your skin’s condition because other conditions can mimic acne. The bumps that can be acne on a teenager may actually be perioral dermatitis, or keratosis pilaris in a child. The same bumps may actually be those of rosacea in an adult over 25. Once your doctor confirms your acne, there are medications and procedures that can clear your skin, ease breakout severity and smooth scars.
While acne is not life threatening, severe forms can result in traumatic, permanent scarring that may negatively affect your self-image, leading to depression and anxiety. Breakouts usually dissipate as you enter adulthood, ending by the age of 24. Some adults will experience outbreaks into their 30s and 40s. Regardless of age, the prognosis is excellent. You will recover from your acne.
If your acne’s severity renders non-prescription medication inadequate, your doctor may prescribe topical (applied to the skin) preparations with active ingredients at levels higher than those allowed in over-the-counter treatments. Your doctor may also prescribe oral medication that spreads throughout the body. Oral medications can include isotretinoin (accutane), antibiotics (erythromycin, clindamycin, tetracycline, minocycline, bactrin or doxycycline), or birth control pills for women. Your doctor may also prescribe retinoids (forms of vitamin A) that influence surface cell growth when applied to your skin. He or she may choose azelaic acid, an organic compound found in barley, rye and wheat. Azelaic acid gel is usually applied twice a day for six months or as your doctor orders.
If you have nodules or cysts, your doctor may combine several medications targeting different stages of pimple formation while killing bacteria. There are also procedures to clear and smooth your skin. The doctor performs these treatments during office visits. Your doctor may suggest you have chemical peels with mild acids (glycolic, lactic or salicylic) or strong acids (30 to 40 percent trichloracetic acid), which are applied to dry skin to effectively peel away one or several skin layers. The stronger the acid the deeper the peel and you will need to follow strict guidelines while healing, as your skin will be extremely sensitive after said treatment.
Dermabrasion, another technique, smooth superficial acne scars. An esthetician, nurse, medical assistant or other health care professional applies abrasives to the skin and physically sands or planes the surface smooth. For severe scarring, laser resurfacing has replaced this procedure and light therapy is another option. Light therapy is a procedure where a dermatologist spreads a sensitizing substance on your pimples and then shines intense, pulsating light on them to kill the bacteria and shrink oil glands.
If all of these sound too harsh, consider holistic acne treatments. Known for its anti-microbial characteristics, some people treat their acne with tea tree oil, applied to the skin. Be careful, because undiluted tea tree oil burns the skin. Other alternative, topical treatments include vinegar, toothpaste, garlic, baking soda, providone iodine, calamine lotion, witch hazel, dead sea salts, hydrogen peroxide, plain yogurt, sea salt, lavender oil, fuller’s earth clay, Epsom salt, rose water and turmeric.
Creating your natural acne treatment saves money while giving you more control over what goes on your skin. Thoroughly mix fuller’s earth clay, plain yogurt and turmeric in a glass bowl to create an anti-acne facial masque. Mix witch hazel with rose water and a few drops of lavender oil to make your own acne fighting, facial astringent. Anytime you try a new potion, apply the ingredients separately to a small patch of skin on your inner arm to see if you have an allergic reaction prior to applying it to your face.
Since the most common forms of acne are inconvenient, but mild, you can manage without seeing your doctor. The most important thing you can do in managing acne is to keep your hands away from your face. You may have noticed clusters of acne pimples where you touch your face out of habit, especially around the mouth and chin or between your eyes. Your hands carry bacteria from every item you touch, so now is a good time to make washing your hands before touching your face a lifelong habit. Shampoo often and keep your hair away from your face. Clean your telephone’s handset and your cell phone with an alcohol-dampened cotton pad.
Avoid sunlight, tanning beds, products with harsh ingredients. Wash your face twice a day and after sweating, and rinse with lukewarm water. Replace your colorful washcloths with plush plain white washcloths to make it easier to see if you have removed all makeup. Pat your face dry with soft towels. Exfoliate with gentle facial scrubs, not the rubbing and scrubbing kind that can make acne worse, and let your skin heal naturally instead of picking at pimples and blackheads.
People have linked acne breakouts to events and behaviors since the first human found that first pubescent pimple. Some are harmless, while others can make you miserable, but all stem from a desire to help. Mothers often warn daughters against wearing makeup during breakouts. You can wear makeup, but powder is not as irritating as cream makeup. Also, be sure to remove all makeup before going to bed, and discard makeup you have had longer than six months.
While stress is probably not a direct acne trigger, your actions while stressed might be. If you rub your forehead or rest your face on your open hands in response to stress, that can trigger an acne outbreak. People have said sunscreen causes acne and since a chemical sunscreen can cause heat bumps, use a physical sunscreen with zinc oxide instead.
Foods cause invisible changes in your body that can lead to more acne pimples. Add whole grains, beans and vegetables to your diet to stabilize insulin production and sip water to boost blood flow and remove toxins. Add flax seed oil, avocados and salmon, or omega-3 supplements to your diet to control sebum production.
Acne’s embarrassing breakouts can result in emotional scars, on top of those left by the more severe forms of acne. As you develop a plan for managing your skin, make some of your treatments as fun as possible. Share time with a close, understanding friend while you both indulge yourselves with homemade, natural facial masques, or use acne as a reason for visiting a spa specializing in problem skin. Experiment with new recipes that include those foods that support healthier skin and a healthier lifestyle.
Topical Therapy for Acne. (n.d.). Retrieved March 28, 2015, from http://www.aafp.org/afp/2000/0115/p357.html
Accutane (isotretinoin) – How it Works, Side Effects, and Reviews – Acne.org. (n.d.). Retrieved March 28, 2015, from http://www.acne.org/accutane.html
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